Preterm birth and Kawasaki disease: a nationwide Japanese population-based study
Preterm birth and Kawasaki disease: a nationwide Japanese population-based study
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DOI：
10.1038/s41390-021-01780-4
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发表时间：
2021-10-08
影响因子：
3.6
通讯作者：
Yorifuji, Takashi
中科院分区：
文献类型：
--
作者：
Takeuchi, Akihito;Namba, Takahiro;Yorifuji, Takashi
背景先前的研究表明，早产增加了婴儿期和儿童期因一些急性疾病而住院的风险。然而，早产儿患川崎病的风险仍然未知。在目前的研究中，我们调查早产是否会增加川崎病的发病率。方法研究对象为日本2010年出生的36,885名儿童，其中足月儿34,880名，早产儿2005名。我们在日本进行了一项大规模的全国性调查，研究了早产与川崎病住院之间的关系。结果在调整了儿童特征(性别、单胎出生和胎次)、父母特征(母亲年龄、母亲吸烟、父亲吸烟、母亲受教育程度和父亲收入)和居住地区的对数线性回归模型中，早产儿更有可能因川崎病住院(调整后的危险比：1中心点55，95%可信区间：1.01-2.39)。然后，我们研究了母乳喂养状态是否改变了早产对健康结局的潜在不利影响。与纯母乳喂养的足月儿相比，部分母乳喂养或配方奶喂养的早产儿因川崎病住院的风险明显更高。结论早产儿是川崎病的高危人群，纯母乳喂养可预防早产儿川崎病的发生。Impact先前的研究表明，早产增加了婴幼儿和儿童由于一些急性疾病而住院的风险，然而，早产儿患川崎病的风险仍然未知。这项基于日本大规模人群的研究首次表明，早产儿患川崎病的风险很高。此外，这项研究表明，纯母乳喂养可以预防早产儿中的川崎病。
Background Previous studies showed that preterm birth increased the risk for hospital admissions in infancy and childhood due to some acute diseases. However, the risk of preterm children developing Kawasaki disease remains unknown. In the present study, we investigate whether preterm birth increased the morbidity of Kawasaki disease. Methods We included 36,885 (34,880 term and 2005 preterm) children born in 2010 in Japan. We examined the association between preterm birth and hospitalization due to Kawasaki disease using a large nationwide survey in Japan. Results In log-linear regression models that were adjusted for children's characteristics (sex, singleton birth, and parity), parental characteristics (maternal age, maternal smoking, paternal smoking, maternal education, and paternal income), and residential area, preterm infants were more likely to be hospitalized due to Kawasaki disease (adjusted risk ratio: 1 center dot 55, 95% confidence interval: 1.01-2.39). We then examined whether breastfeeding status modified the potential adverse effects of preterm birth on health outcome. Preterm infants with partial breastfeeding or formula feeding had a significantly higher risk of hospitalization due to Kawasaki disease compared with term infants with exclusive breastfeeding. Conclusions Preterm infants were at a high risk for Kawasaki disease, and exclusive breastfeeding might prevent this disease among preterm infants. Impact Previous studies showed that preterm birth increased the risk for hospital admissions in infancy and childhood due to some acute diseases, however, the risk of preterm children developing Kawasaki disease remains unknown. This Japanese large population-based study showed that preterm infants were at a high risk for Kawasaki disease for the first time. Furthermore, this study suggested that exclusively breastfeeding might prevent Kawasaki disease among preterm infants.